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Breast reduction performed by Liposuction

Our Services / Breast reduction performed by Liposuction

Reasons for Breast Reductions

 

  • Excess weight from the breast can cause:

 

Pain/aches around the upper body
Bad posture
Unwanted attention and self consciousness
Difficulties with bras (indentation, rashes, redness) and fitting into clothing
Appearance of a disproportional body (including severe cases of asymmetrical breast)

 

Background

Scarless breast reduction is a form of customized liposuction for the breast that is a less invasive method for breast reduction. The main factor that determines breast size is the amount of fat tissues found within the breast. As fat is removed via cannula, the breast size is reduced. The average volume of reduction can range from 300 ml – 800ml per. breast and maximum is up to 2250 ml per. breast, however the most ideal volume of removal is less than 500 ml.

 

The procedure aims to remove fat with the use of a cannula – the same tool used in liposuction for other areas of the body (i.e stomach). In addition, ultrasound can be used to further assist the procedure (optional). It is a less invasive procedure compared to original technique for breast reduction because it does not require the removal of the breast parenchyma and supporting structures. Also it is only required for the patient to be under local anesthesia and sedation.

 

Statistics (2014 – ASPS)

 

  • Reconstructive Patients only:

A total of 59, 883 breast reduction procedures were performed

 

  • Aesthetic Patients only:

A total of 41, 309 breast reduction procedures were performed

 

  • In men (Gynecomastia):

A total of 26, 175 breast reduction procedures were performed
There has been a 29% increase since 2000!

 

  • Total of: 127, 317 reported procedures related to breast reduction

 

Ideal Patients

 

  • Younger individuals with minor, fatty hypertrophy and pleasing breast shape with no ptosis

 

  • With reason: older individuals with large hypertrophy that places importance of reduction in breast volume over achieving aesthetically pleasing breast shape

 

  • Women with hyperplasia

 

Patient Evaluation

 

  • Generally speaking,

Lower BMI patients and younger patients will have higher glandular content in breast
Higher BMI patients and older patients will have higher fat content in breast (however, not always the case for higher BMI)
Patients with normal BMI are more likely to have a larger breast reduction

 

  • Successful results depends on which factors patients place more importance on:

 

Breast shape
Breast volume
Size of scar
For instance, some patients may sacrifice smaller scar tissue for a more aesthetically appealing breast shape

 

  • Assessment of: shape, size, symmetry, droopiness, stretch marks, and skin elasticity

 

Algorithm of Young Patients

 

  • Reductions (< 500 cc)

BMI > 25 – Liposuction
BMI < 25 – Resection technique
However, BMI does not always account for localized fat – higher BMI could be due to excess fat in other parts of the body, including/excluding the breast

 

  • Reductions (>500 cc)

Will depend on patient’s aesthetic concerns/history of hypertrophic scaring

 

Algorithm for elderly patients

 

  • Atheistically pleasing breast shape wanted:

Resection Technique
No concerns for atheistically pleasing breast shape:
Reduction (< 500 cc) = liposuction
Reduction (> 500 cc) = resection technique

 

SCARLESS PROCEDURE

 

  • Standard Mammography is performed before procedure (because firmness of breast does not correlate with fat content)

 

  • Patient is placed in a seated position

 

  • Length of procedure is approximately one hour

 

  • Infiltration using tumescent solution is administered into the breast

 

  • After infiltration, one small (quarter-inch) incision for each breast is made along the inframammary crease

 

  • A cannula (3-4 mm) is inserted through a medial and lateral inframammary incision, where fat is suctioned into the tube by breaking down the fat layers in the breast

 

The subareolar and upper lateral quadrant should receive a less aggressive suction

 

  • The skin naturally follows the curvature/shape of the breast during/after the breast reductioncannula

 

 

Complications

 

  • Hematoma
  • Erthema (older patients)
  • Tenderness (temporarily)
  • Bruising
  • Seroma
  • Mastopexies
  • Contact dermatitis
  • Blisters
  • Infections

 

 

Advantages

 

  • Cheaper cost and faster recovery time

takes up to a maximum of one week to fully heal

  • Less complications:

Little to no scarring (massaging scar tissue can reduce appearance)
Less risk in impairing lactation/breast feeding capacity
Less risk with causing damage to glandular tissue

  • May also result in elevation of the nipple-areolar complex (average of 6 cm, with a range between 2-12cm)

Enlarged areolas may contract as well

  • Potential future applications for breast cancer treatments
  • Patient satisfaction is generally high

 

Disadvantages

 

  • Not ideal for reshaping

Relies heavily on the ability of patient’s skin to retract

  • Patients with higher glandular tissue content will have difficulties in achieving reduction for larger volumes (more aggressive suctioning can lead to damage)
  • As fat is removed, the density of the breast increases – poses a risk in interfering with cancer detection that requires the use of imaging technology

 

EXCISION/CONVENTIONAL PROCEDURE

 

  • Long incisions are made on both breast (12 inch) at the inframammary crease or under the areolas
  • Removal of selective fat tissue and/or glandular tissue
  • May need to surgically readjust the orientation of the nipple
  • As a consequence, procedure requires heavier sedation, longer surgery time, and poses a higher risk of:

 

Infection
Blood loss
Inability to breast feed
Loss of nipple sensation
Pain